A National Population-based Study of Adults With Coronary Artery Disease and Coarctation of the Aorta.

Adults with repaired coarctation of the aorta (CoA) suffer reduced long-term survival compared with the general population, in part due to coronary artery disease (CAD). There is conflicting evidence as to whether or not CoA is an independent risk factor for CAD. The primary aim was to determine if CoA is independently associated with premature myocardial infarction (MI) in the contemporary era.

The psychology of Tourette disorder: Revisiting the past and moving toward a cognitively-oriented future.

Tourette syndrome is a neurodevelopmental disorder characterized by chronic tics (i.e., repetitive and stereotyped movements and vocalizations) and premonitory urges (i.

General Population vs. Patient Preferences in Anticoagulant Therapy: A Discrete Choice Experiment.

Objectives: Preference weights derived from general population samples are often used for therapeutic decision making. In contrast, patients with cardiovascular disease may have different preferences concerning the benefits and risks of anticoagulant therapy. Using a discrete choice experiment, we compared preferences for anticoagulant treatment outcomes between the general population and patients with cardiovascular disease.

Instructor-led vs. peer-led debriefing in preoperative care simulation using standardized patients.

Background: Debriefing involves the active participation of learners to identify and close gaps in knowledge and skills. Varied debriefing methods are used in simulation, but no empirical studies have examined the effectiveness of peer-led debriefing in simulation using standardized patients. The purpose of this study was to compare the effects of two debriefing methods (instructor-led vs.

Characteristics of early sacubitril/valsartan patients and considerations for studies in electronic health record data.

Aim: We examined characteristics of early sacubitril/valsartan users in a large US electronic health records database.

Patients & Methods: We identified three cohorts of patients with heart failure (HF): sacubitril/valsartan patients with a prior HF diagnosis; patients with HF with reduced ejection fraction; and patients with HF treated with an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker and a β-blocker.

Results: Sacubitril/valsartan patients were younger than patients in the other cohorts; the mean age of sacubitril/valsartan patients increased by 2 years in the first 15 months of marketing.

Learning Cybercivility: A Qualitative Needs Assessment of Health Professions Students.

Background: Literature on cyberincivility in health professions education has mainly focused on intraprofessional communication. This study explored health professions students' experiences with cyberincivility, as well as their perspectives on interprofessional cybercivility learning.

Method: This qualitative study used semistructured interviews with a purposive sample of 25 students in nursing, medicine, physician assistant, or physical therapy programs at a private university in the United States.

Evaluation of Switching Patterns in FDA's Sentinel System: A New Tool to Assess Generic Drugs.

Introduction: Nearly 90% of drugs dispensed in the US are generic products.

Objective: The aim of this study was to develop and implement a tool for analyzing manufacturer-level drug utilization and switching patterns within the US Food and Drug Administration's Sentinel system.

Methods: A descriptive tool was designed to analyze data in the Sentinel common data model and was tested with two case studies-metoprolol extended release (ER) and lamotrigine ER-using claims data from four Sentinel data partners.

Using Real-World Data to Extrapolate Evidence From Randomized Controlled Trials.

Randomized controlled trials (RCTs) provide evidence for regulatory agencies, shape clinical practice, influence formulary decisions, and have important implications for patients. However, many patient groups that are major consumers of drugs are under-represented in randomized trials. We review three methods to extrapolate evidence from trial participants to different target populations following market approval and discuss how these could be implemented in practice to support regulatory and health technology assessment decisions.

Opioid Overdose After Surgical Discharge.

This pharmacoepidemiology study uses commercial claims database data to describe the rate of opioid overdose 1 to 3 months after surgical discharge by dose and procedure from 2004 to 2015.

Effect of a Remotely Delivered Tailored Multicomponent Approach to Enhance Medication Taking for Patients With Hyperlipidemia, Hypertension, and Diabetes: The STIC2IT Cluster Randomized Clinical Trial.

Importance: Approximately half of patients with chronic conditions are nonadherent to prescribed medications, and interventions have been only modestly effective.

Objective: To evaluate the effect of a remotely delivered multicomponent behaviorally tailored intervention on adherence to medications for hyperlipidemia, hypertension, and diabetes.

Design, Setting, And Participants: Two-arm pragmatic cluster randomized controlled trial at a multispecialty group practice including participants 18 to 85 years old with suboptimal hyperlipidemia, hypertension, or diabetes disease control, and who were nonadherent to prescribed medications for these conditions.

Data Mining for Adverse Drug Events With a Propensity Score-matched Tree-based Scan Statistic.

The tree-based scan statistic is a statistical data mining tool that has been used for signal detection with a self-controlled design in vaccine safety studies. This disproportionality statistic adjusts for multiple testing in evaluation of thousands of potential adverse events. However, many drug safety questions are not well suited for self-controlled analysis.

Aurora kinase A localises to mitochondria to control organelle dynamics and energy production.

Many epithelial cancers show cell cycle dysfunction tightly correlated with the overexpression of the serine/threonine kinase Aurora A (AURKA). Its role in mitotic progression has been extensively characterised, and evidence for new AURKA functions emerges. Here, we reveal that AURKA is located and imported in mitochondria in several human cancer cell lines.

Effect of Lawyer-Submitted Reports on Signals of Disproportional Reporting in the Food and Drug Administration's Adverse Event Reporting System.

Introduction: Lawyer-submitted reports may have unintended consequences on safety signal detection in spontaneous adverse event reporting systems.

Objective: Our objective was to assess the impact of lawyer-submitted reports primarily for one adverse event (AE) on the ability to detect a signal of disproportional reporting for another AE for the same drug in the US FDA Adverse Event Reporting System (FAERS).

Methods: FAERS reports from January 2004 to September 2015 were used to estimate yearly cumulative proportional reporting ratios (PRRs) for three known drug-AE pairs-isotretinoin-birth defects, atorvastatin-rhabdomyolysis, and rosuvastatin-rhabdomyolysis-with and without lawyer-submitted reports.

Evaluation of selected ultra-trace minerals in commercially available dry dog foods.

Purpose: To evaluate the concentrations of chromium, nickel, molybdenum, silica, and aluminum in several commercially available dry dog foods and compare these with current World Health Organization's (WHO) mean human daily dietary intake. Conversion of dietary intake per megacalorie (Mcal) for both dog foods and human average intake was performed based on the National Research Council recommendation of a 2,900 kcal diet for comparative purposes to average intake and potential toxic exposure.

Materials And Methods: Forty-nine over-the-counter dry foods formulated for maintenance of healthy dogs yet listed as all life stage foods were analyzed.

Use of rheumatology-specific patient navigators to understand and reduce barriers to medication adherence: Analysis of qualitative findings.

Objective: Adherence to medications among patients with rheumatic diseases is often suboptimal. Patient navigators, individuals trained in care coordination, motivational interviewing and basic rheumatology and pharmacology, have not been employed to explore and address this issue. We piloted a single-site, single arm intervention to determine the feasibility and acceptability of using rheumatology-specific navigators to understand and reduce barriers to adherence to oral disease modifying anti-rheumatic drugs (DMARDs).

Defining Exposure in Observational Studies Comparing Outcomes of Treatment Discontinuation.

Background: Continuation of antiplatelet therapy beyond 12 months after a drug-eluting stent procedure reduced the risk of a major adverse cardiovascular and cerebrovascular event (MACCE) in the DAPT trial (Dual Antiplatelet Therapy). Observational studies have evaluated outcomes related to different durations of therapy but are susceptible to bias.

Methods And Results: Using deidentified claims from commercially insured and Medicare populations in the United States, we compared how increasingly stringent definitions of exposure affect associations between antiplatelet continuation versus discontinuation and MACCE, myocardial infarction, and intracerebral hemorrhage or gastrointestinal bleeding in patients meeting DAPT trial inclusion criteria between 2004 and 2013.

Drug utilization patterns and adherence in patients on systemic medications for the treatment of psoriasis: A retrospective, comparative cohort study.

Background: Nonadherence to systemic treatments for psoriasis leads to treatment failure and increased health care utilization.

Objective: Examine drug utilization patterns and adherence of new users of systemic medications for psoriasis.

Methods: We conducted a retrospective, comparative cohort study using a large US health insurance claims database including psoriasis patients who were new users of acitretin, adalimumab, etanercept, methotrexate, or ustekinumab.

Extension of Disease Risk Score-Based Confounding Adjustments for Multiple Outcomes of Interest: An Empirical Evaluation.

Use of disease risk score (DRS)-based confounding adjustment when estimating treatment effects on multiple outcomes is not well studied. We designed an empirical cohort study to compare dabigatran initiators and warfarin initiators with respect to risks of ischemic stroke and major bleeding in 12 sequential monitoring periods (90 days each), using data from the Truven Marketscan database (Truven Health Analytics, Ann Arbor, Michigan). We implemented 2 approaches to combine DRS for multiple outcomes: 1) 1:1 matching on prognostic propensity scores (PPS), created using DRS for bleeding and stroke as independent variables in a propensity score (PS) model; and 2) simultaneous 1:1 matching on DRS for bleeding and stroke using Mahalanobis distance (M-distance), and compared their performance with that of traditional PS matching.

A closed formula for calculating pesticide residue levels in the feed items of terrestrial species.

Calculating pesticide residue levels in feed items for terrestrial species requires accounting for the application rate of the pesticide, the frequency and interval of application, the half-life of the pesticide on the food item, and the residue unit dose. Microsoft Excel™-based applications such as the US Environmental Protection Agency's Terrestrial Residue Exposure model (T-REX) and Terrestrial Herpetofaunal Exposure Residue Program (T-HERPS) calculate the residue levels in feed items using a recursive sequence. A recursive sequence is an unwieldy calculation method that presents a barrier to creating a software-based tool capable of conducting flexible assessments.

Assessing the impact of the new ICD-10-CM coding system on pharmacoepidemiologic studies-An application to the known association between angiotensin-converting enzyme inhibitors and angioedema.

Purpose: To replicate the well-established association between angiotensin-converting enzyme inhibitors versus beta blockers and angioedema in the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) era.

Methods: We conducted a retrospective, inception cohort study in a large insurance database formatted to the Sentinel Common Data Model. We defined study periods spanning the ICD-9-CM era only, ICD-10-CM era only, and ICD-9-CM and ICD-10-CM era and conducted simple-forward mapping (SFM), simple-backward mapping (SBM), and forward-backward mapping (FBM) referencing the General Equivalence Mappings to translate the outcome (angioedema) and covariates from ICD-9-CM to ICD-10-CM.

Diagnosis-based cohort augmentation using laboratory results data: The case of chronic kidney disease.

Purpose: In this report, we use data from FDA's Sentinel System to focus on how augmenting a diagnosis-based chronic kidney disease cohort with patients identified through laboratory results impacts cohort characteristics and outcomes.

Methods: We used data from 2 Data Partners. Patients were eligible if they were health plan members on January 1, 2012.

Direct Phosphorylation of SRC Homology 3 Domains by Tyrosine Kinase Receptors Disassembles Ligand-Induced Signaling Networks.

Phosphotyrosine (pTyr) signaling has evolved into a key cell-to-cell communication system. Activated receptor tyrosine kinases (RTKs) initiate several pTyr-dependent signaling networks by creating the docking sites required for the assembly of protein complexes. However, the mechanisms leading to network disassembly and its consequence on signal transduction remain essentially unknown.